Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2004
Randomized Controlled Trial Clinical TrialThe effect of premedication with OTFC, with or without ondansetron, on postoperative agitation, and nausea and vomiting in pediatric ambulatory patients.
The purpose of this study was to evaluate, in the pediatric ambulatory surgical population, the efficacy of: (i) oral transmucosal fentanyl citrate (OTFC), when given preoperatively, to reduce postoperative excitement associated with sevoflurane, and (ii) intravenous ondansetron to reduce postoperative nausea and vomiting (PONV) associated with OTFC. ⋯ Even though OTFC reduced early postoperative agitation the increase in side effects, namely PONV and prolonged recovery times, limits its clinical usefulness. The study demonstrates the tradeoffs between anxiety and agitation vs vomiting, respiratory events and prolonged recovery times. Ambulatory pediatric patients undergoing procedures in which opioids would be routinely used might benefit the most from OTFC combined with ondansetron as part of the anesthetic technique.
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Paediatric anaesthesia · Sep 2004
Randomized Controlled Trial Comparative Study Clinical TrialEffectiveness of morphine via thoracic epidural vs intravenous infusion on postthoracotomy pain and stress response in children.
Thoracotomy causes severe pain in the postoperative period. The aim was to evaluate effectiveness of two pain treatment methods with morphine on postthoracotomy pain and stress response. ⋯ Single dose TEP morphine offers no advantage over INF for pain treatment for thoracotomy in children and neither technique provided suppression of stress hormones in the first 24 h postoperatively.
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Anesthetic management of a 3-month-old boy with Beckwith-Wiedemann syndrome for bronchoscopy is reported. Management may be complicated by a difficult airway, congenital heart disease, and hypoglycemia. We did not have difficulty in airway management either with tracheal intubation or rigid bronchoscopy, but we could not extubate the baby because of tracheomalacia.